Capsule endoscopy is a method of examining the interior of a patient's gastrointestinal tract using an endoscopy capsule or “camera pill” that includes a miniaturized camera and a light source inside an ingestible capsule. Typically, the patient swallows the endoscopy capsule, which takes a series of pictures as it passes through the patient's digestive system and transmits the images to a receiver external to the patient. The endoscopy capsule passes out of the digestive system in the patient's stool and is discarded. Capsule endoscopy has proven to be most valuable in examining and diagnosing a patient's small intestine, as this portion of the gastrointestinal tract is not readily accessible using standard flexible endoscopy methods.
Recent studies have investigated the use of capsule endoscopy for examination of a patient's esophagus, particularly for diagnosing Barrett's esophagus, a precancerous condition associated with chronic gastroesophageal reflux disease (GERD). Success of these studies has been hampered in part by the fast transit time of the endoscopy capsule through the esophagus (typically 1-8 seconds), as compared to other portions of the gastrointestinal tract. The rapid transit time allows only a few images to be taken of the esophagus (typically 4-11 images) and many times the area of greatest interest at the gastroesophageal junction or “Z-line” is missed entirely. Efforts to improve the effectiveness of capsule endoscopy of the esophagus have included having the patients examined in a supine position to slow down the transit time of the capsule through the esophagus, taking more images per minute, and having patients swallow a capsule with a string attached to it to retard the passage of the capsule through the esophagus. However, these measures have not proven to be entirely effective. Even the most successful studies to date have had results that would make esophageal capsule endoscopy appropriate only as a screening tool and not as an accurate diagnostic technique.
Systems have been proposed for stereotactic positioning or steering of instruments, such as needles, catheters and endoscopy capsules, within a patient's body using externally applied magnetic fields. These systems are generally very complex and expensive, and it would be cost-prohibitive to use these systems for all routine esophageal capsule endoscopy examinations.
What is needed and has not been available heretofore is an effective and cost-efficient means for locating, positioning, steering and tracking of an endoscopy capsule within a patient's esophagus.
The following medical articles, patents and patent applications, which describe various aspects of capsule endoscopy and related technologies, are hereby incorporated by reference.
Capsule endoscopy of the esophagus?; A Németh, I Rácz; 1st Department of Internal Medicine, Petz Aladár County and Teaching Hospital, Gyor; Zeitschrift für Gastroenterologie; DOI: 10.1055/s-2004-827003 lecture
Capsule endoscopy: Can it replace upper endoscopy to screen for Barrett's esophagus?; F. Schnoll-Sussman, A. Hernandez, M. Bigg; 2004 Gastrointestinal Cancers Symposium; SubCategory: Upper GI Cancer (Esophageal and Gastric); Abstract No: 43
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Capsule endoscopy is also used for imaging of the small intestine, especially to look for bleeding and inflammatory bowel disease. Currently available imaging capsules, as described in the publications listed above, use only the visible spectrum of light and the images are seen as regular images.
Endoscopic spectroscopy is an emerging technology for diagnosis of cancer and other diseases within a patient's body. Spectroscopic examination can be used to identify lesions that are not readily visible using white light endoscopy and/or to diagnose or differentiate tissues of suspected lesions that are found using white light endoscopy or other techniques. Auto fluorescence is a spectroscopic technique that illuminates a patient's tissues with one or more excitation frequencies and measures and/or images the natural fluorescence of the tissues. Differences in the natural fluorescence can be used to distinguish between normal cells and certain types of diseased cells. Dye-enhanced fluorescence is a spectroscopic technique in which one or more special fluorescent marker dyes are applied to the tissues either topically or systemically. The tissues are then illuminated with one or more excitation frequencies and the fluorescence of the tissues is measured and/or imaged. Differences in the uptake of the fluorescent marker dyes can be used to identify lesions and/or to distinguish between normal cells and certain types of diseased cells. Other known spectroscopic techniques can also be used. The following U.S. patents and patent applications, each of which is incorporated herein by reference in its entirety, describe various spectroscopic techniques that can also be used in connection with the present invention:
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